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Vap croc
- 1. Managing the Complex Care of the Critically and Acutely Ill Patient
- 4. (VAP) is a hospital-acquired lung infection that occurs in patients receiving mechanical ventilation and for whom the infection was not the reason for the ventilation.
- 6. Clinical suspicion (≥ 48h of hospital stay) new or progressing pulmonary Rx infiltrate + one of the following clinical criteria: - fever >100.4 degrees °F or lower than 96.8 °F - white blood count greater than 10,000 - purulent sputum. with microbiological confirmation
- 7. Longer duration of mechanical ventilation Advanced age Depressed level of consciousness Preexisting lung disease Immune suppression from disease or medication Malnutrition
- 9. Every 2 hours One every 24 hours with chlorhexidine Attention to all surfaces Use a wetting agent
- 10. >= 30 degrees
- 12. Head of the bed elevated or flat? Femoral line Drainage of glottic secretions Hypotension Tube feeding Mouth Care When do you it? Oral Trauma Gag reflex.
- 13. Taken from Creative Commons Sage Manufacturing Peter Pan © 1953 the Walt Disney Company
Editor's Notes
- How to Use This Tool: This presentation is designed as a tool to educate teams about the ABCDE Bundle. It provides a brief introduction to the evidence-based patient care strategies designed to minimize the unintended consequences associated with acute and critical illness. While all of this content is applicable to mechanically ventilated adult patients, elements of the ABCDE bundle apply to all patients with acute or critical illness, no matter where their physical location. If you work in a Pediatric Intensive Care Unit, your patients are equally at risk for developing similar unintended consequences as their adult counterparts. Unfortunately, there is little research available on the effectiveness of awakening and breathing trials or mobility protocols in the pediatric population. However, there is an evidence-based, valid and reliable tool to assess for pediatric delirium. Overall the tools, drugs and assessment parameters may differ but the approach is similar across all age groups along the continuum of acute and critical illness. When applying the elements of the ABCDE Bundle to a pediatric or progressive care population, it is important to look at the risk of using a tool or assessment vs. the benefit of implementation to improve patient outcomes. This presentation may be used in its entirety as-is or supplemented with your organization-specific resources. It can also be broken down into short in-services or used for poster presentations. The presentation includes: Introduction to the ABCDE Bundle Benefits of the ABCDE Bundle Awakening and Breathing Trial Coordination elements Delirium Assessment and Management elements Early Exercise and Progressive Mobility elements